Prestroke glucose control and functional outcome in patients with acute large vessel occlusive stroke and diabetes after thrombectomy

Jun Young Chang, Wook Joo Kim, Ji Hyun Kwon, Beom Joon Kim, Joon Tae Kim, Jun Lee, Jae Kwan Cha, Dae Hyun Kim, Yong Jin Cho, Keun Sik Hong, Soo Joo Lee, Jong Moo Park, Byung Chul Lee, Mi Sun Oh, Sang Hwa Lee, Chulho Kim, Dong Eog Kim, Kyung Bok Lee, Tae Hwan Park, Jay Chol ChoiDong Ick Shin, Sung Il Sohn, Jeong Ho Hong, Ji Sung Lee, Hee Joon Bae, Moon Ku Han

Research output: Contribution to journalArticlepeer-review

11 Scopus citations

Abstract

OBJECTIVE To evaluate whether prestroke glucose control is associated with functional outcomes in patients with acute large vessel occlusive stroke and diabetes who underwent intra-arterial thrombectomy (IAT). RESEARCH DESIGN AND METHODS From the Clinical Research Center for Stroke–Korea registry, we included patients with emergent large vessel occlusive stroke with diabetes who underwent IAT between January 2009 and March 2020. The association between the HbA1c level at admission and functional outcomes (modified Rankin Scale at 3 months after the index stroke) was assessed. RESULTS A total of 1,351 patients were analyzed. Early neurological deterioration was more common in patients with higher levels of HbA1c at admission (P = 0.02 according to HbA1c quintiles, P = 0.003 according to an HbA1c cutoff value of 7.0%) than in those with lower HbA1c levels. Higher HbA1c levels at admission were significantly associated with decreased odds of favorable functional outcomes at a threshold of 7.0–7.1%. The association was consistently observed in subgroups divided according to age, sex, stroke subtype, occlusion site, degree of recanalization, thrombolysis modalities, time from symptom onset to groin puncture, and treatment period. CONCLUSIONS Prestroke glucose control with a target HbA1c of #7.0% may be beneficial for neurological recovery in patients with diabetes undergoing IAT for large vessel occlusive stroke, regardless of stroke subtype, bridging intravenous thrombolysis, occlusion site, degree of recanalization, and treatment period.

Original languageEnglish
Pages (from-to)2140-2148
Number of pages9
JournalDiabetes Care
Volume44
Issue number9
DOIs
StatePublished - 1 Sep 2021

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